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INTRODUCTION |
 Phenomenal progress in Research and Development
in medicinal sciences has increased the life expectancy of human
beings. No doubt this is a great achievement! But the increase in
average life expectancy is resulting in an increasing prevalence of
1 major invalidating illnesses.
The life should not be evaluated only in terms of
length. The real issue is that can we live longer while still being
active and free of diseases? If the answer for question is 'NO' the
future seems to be gloomy.
The matter is serious! To solve this problem it is
essential to understand what aging is and what are the age related
health problems. |
| WHAT IS AGING ? |
 Human body continuously changes as the age
advances. There is a change in cells, tissues, organs and system
functions. Practically speaking aging is any change in an organism
over time.
The rate of aging differs from person to person and it
depends on the genetic structure and environment. It is proposed
that genetic structure has more influence on age than
environmental factor.
Aging produces various changes in human body:
internal and external. External changes are like change in posture,
forward bending of spine, increased curvatures of hip and knee, etc.
Weight is also gradually reduced with aging.
Specific changes, associated with aging, in human body
are linked with specific disorders. For example multiplication of
some white cells slows down with the age which results in reduced
defense function of human body. Apoptosis is programmed cell
death of the cells. It is the process by which cells are self destructed at
appropriate time. The program gets hampered with age. That is one
of the reasons why some cancers are more common in elderly
population. Lack of apoptosis allows cells to live for indefinite time.
The cancer cells continue to multiply and invade or take over
surrounding tissue, instead of dying as originally programmed.
Alzheimer's disease is another important age related disorder in
which a substance called amyloid gets accumulated in brain. It
causes early death of brain cells and results in memory loss.
Surprisingly aging of an individual is not same for all the
systems. A person who develops aging related disorder of one
system or organ may not experience any age related disease for
other organ or system. |
| AGE RELATED DISORDERS |
| It is due to the close relation of process of aging and
various body functions disease and disability is much more common
in the elderly population than in people younger than 65. An aging
related disease is a disease that is seen with increasing frequency
with increasing aging. Age-associated diseases are to be
distinguished from the ageing process itself because all adult animals age, but not all adult animals experience all age-associated
diseases. The incidence of all of these diseases increases rapidly with
aging. Following are some important diseases that can be seen at
any age, but are more common among the elderly. |
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 Alzheimer's disease
Alzheimer's
disease is a disorder
o f the brain
characterized by
deterioration in the
mental capacity.
Loss of
rec ent
memory, inability to
recognize known
people and places
are early signs of the
di sease. In the
progression of this
disease intellectual functions are gradually lost. |
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 Osteoarthritis
Arthritisis
inf lammat ion ( rednes s,
swelling, pain, increased
temperature and loss of
function) of joints. There are
many forms of arthritis.
Osteoarthritis is the most
common form and the most
frequent joint disorder in
seniors. Osteoarthritis is due
to the wearing down of cartilage, which is the material that
cushions the ends of the bones.
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 Osteoporosis
Osteoporosis is
decreased density of bones.
In other words it is thinning
and weakening of bones.
This is most commonly
observed in females after
menopause (when monthly
periods stop). |
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 AMD (Age related macular degeneration)
Age - related
Macular Degeneration (AMD)
is a common disorder that
causes irreversible loss of
central vision. Retina is the
back screen of the eye ball
where image of the object is
formed. Macula is the central
part of the retina. AMD is age
related damage of macula. |
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 Parkinson's disease
It is the disease of
nervous system caused due
to deficiency of a substance
called dopamine. Parkinson's
disease leads to tremors,
weakness of muscles, rigidity,
and slowness of movements. |
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 Cataract
Cataract is a
disease of lens of eye. The
proteins, in the lens, are
arranged in such a precise
manner that keeps the lens
clear and yet lets light pass
through it. The process of
ageing brings with it
degeneration of the structure.
What happens is some of the protein in the lens clumps together
and starts to cloud a small area of the lens. This is a cataract, and
over time, the clump can grow larger and cloud more of the lens,
making it harder to see. Cataract can lead to blindness. |
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 Cardiovascular disorders
Cardio means related to
heart and vascular means related to
blood vessels. Age related cardiovascular
disorders include various diseases of
blood vessels and heart. Hypertension
(rise in blood pressure), atherosclerosis
(hardening of arteries due to deposition
of cholesterol) are the common
cardiovascular disorders. They can lead
to heart attack and death. |
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 Cancer
Tumor or neoplasm is a spontaneous new growth of
tissue forming an abnormal mass. It serves no constructive function
and grows at the expense of the healthy organism. Tumors are
broadly classified into two types: Benign and Malignant. It is the
malignant tumor that is termed as cancer. They grow rapidly and
they infiltrate and destruct surrounding tissue and they can extend
beyond the tissue of origin into neighboring organ. Cells from
malignant tumors can get dislodged from the original site and enter
into the blood circulation. Along with the blood they are circulated
all over the body. They escape from the circulation and get lodged
into some different organ and develop a new tumor. |
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Tuberculosis
Tuberculosis is an infection caused by the
Mycobacterium tuberculosis. It usually
affects the lungs, but can infect any organ.
 The elderly are also frequently classified as
being particularly susceptible to air
pollution. The basis of this increased
sensitivity is not known but it is likely that it is
linked to age-related impaired function of
the lung3.
A lot of research has been conducted to
explore the relation of aging to various
disorders. Scientific observation has shown
that aging causes reduced ability to use
calories from food, reduced function of
hormones, depressed enzyme function, and
reduced ability to fight disease.
When the association between aging and age related
disorders was further researched and studied in detail the world
over, after a long deliberation, scientists were able to pinpoint one
more culprit. It was found that the oxidative stress generated in the
human body was doing the age related damage. Let's see what
“Oxidative Stress' is and how it plays a role in furthering or causing
age related diseases. |
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OXIDATIVE STRESS AND AGE
To understand the role of oxidative stress one must
know about free radicals. An atom has protons and neutrons at its
center and electrons revolving around the center in orbits. In normal
conditions, these electrons are found in pairs. If an electron
revolving around the center is not paired, the species is called as a
free radical.
 Free radicals are unstable and highly reactive. To
achieve stability they 'rob' electrons from the surrounding molecules
to produce an electron pair. Due to this, the molecule from which
the electron is removed becomes unstable and turns into a free
radical. This process of 'robbing' repeats with the new free radical
and the chain progresses.
In this way, a single radical is capable of producing a
sequence of electron transfer reactions. The process of the removal
of electron is called as oxidation. And the stress thus generated by
the free radicals is called as oxidative stress.
These free radicals attack fatty acids and proteins in cell
membranes and cause damage to it. Free radicals also damage the
DNA. Studies have proved that the oxidative stress is implicated in
the development of a variety of diseases like Heart diseases,
Osteoporosis, Cancer, Hypertension, Diabetes mellitus, Alzheimer's
disease, Parkinson's disease, Arthritis, Cataract, etc. One can easily
make out that excess oxidative stress is associated with almost all
important disorders which are related to age. This gives a clear-cut
indication of the fact that oxidative stress is associated with the
process of aging. |
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THE PROBLEM IS COMPLICATED!
The number of senior citizens in the India is rapidly
increasing. The likelihood of having more than one disease also
increases as we age. Presence of two or more diseases at a time
complicates the management of individual disorder.
 Let us take an example of an old person has heart
disease and arthritis. To protect heart and blood vessels the person
is supposed to do daily exercise, but joint pains due to arthritis may
not allow the person to do it. As a result not only the risk of heart
disease will increase but also the person will gain weight and add
additional burden on damaged joints.
More disorders will always demand more medications.
Every drug has got some or other adverse effect. Long term
administration of medications may produce an absolutely new
disease. For example if an old person is taking medications for
arthritis for a long time, he will experience burning pain in the
stomach due to increased acid secretion. This is because the drugs
commonly used in arthritis are known to stimulate secretion of acid
in stomach. Subsequently the risk for development of stomach ulcer
also increases. Use two or more drugs together is also responsible
for different drug-drug interactions. It means when two or more
drugs are administered together one drug may reduce the effects of other drug/s or may increase the chances of side effects of the drugs.
Older adults are also hospitalized more frequently than younger. |
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IS THERE ANY SOLUTION FOR
AGE RELATED DISORDERS?
It is a fact that aging cannot be prevented completely.
But something can be done. We have seen that aging is controlled
by genetic and environmental factors. We cannot control genetic
structure but we can definitely take care of environmental factors up
to certain extent. Various life-style factors have positive impact on
the process of aging.
The factors are
 NO SMOKING
NO OR MODERATE CONSUMPTION OF ALCOHOL
REGULAR EXERCISE
SUFFICIENT REST
EMOTIONAL STABILITY
HEALTHY NUTRITIONAL INTAKE
To understand exact role of nutrition in aging, one must
know the concept of ANTIOXIDANTS. |
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ANTIOXIDANTS
Antioxidants are substances whose presence, in
relatively low concentrations, significantly inhibits the rate of
oxidation. It is the counter to the process of oxidation. Antioxidants
deal with these free radicals and control oxidative stress. Every
person, in old age is exposed to additional oxidative stress due to an
excessive burden of free radicals. To neutralize this oxidative stress
human body has a store of natural antioxidants present in the form
of various secretions such as albumin, bilirubin, estrogen, etc. These
are the Natural (physiological) antioxidants that human body uses to
fight off the potential (damage) threat posed by oxidative stress.
But, these natural antioxidants that are synthesized in
human bodies may not be always sufficient to take care of the
additional burden of free radicals that are generated during the
process of aging. So, one need to extract extra antioxidants from the
diet. |
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NUTRITION, ANTIOXIDANTS
AND AGING
Under-nutrition amongst
older people is a global crisis.
Food intake declines with age,
and elder ly individual s
frequently report a decrease in appetite4.
Studies have proved that older
people are at an increased risk
of reduced energy and nutritional intake5.
 A large body of scientific evidence doubtlessly indicates
that an association exists between inadequate antioxidant status
and increased risk for or poor outcome of several age-related
diseases, including Alzheimer's disease, heart failure, cardiovascular
diseases, osteoporosis, cancer, osteoarthritis, degenerative diseases of the eye, etc
6,7,8.
The nutritional deficiency in aged population is not
limited to major components like carbohydrates and proteins.
During aging levels of antioxidant micronutrients may fall below
normal ranges. That is the reason why nutrition that will provide adequate antioxidants should be consumed by elderly population,
which is experiencing the excess burden of oxidative stress. Thus
nutrition is one promising means of protecting the body from the
age related disorders. But there are limitations, especially in old age!
Lack of appetite due to natural aging, various diseases, adverse
effects of various medications, age related reduction in efficiency of
digestive system are some of the reasons for unhealthy nutritional
status of the older people. Impaired ability of smelling function
causes reduced enjoyment of food, which in turn may lead to
reduced intake of food. And above all the supposedly “modern”,
and deviously unhealthy, food habits prevent the sufficient intake of
the much needed dietary antioxidants.
This is the reason why individuals who are predisposed
to the age related disorders need additional supply of antioxidants.
Therefore supplementation with antioxidants appears to be an
attractive possibility to delay the onset of age related disorders.
Various herbal antioxidants present in nature have the
potential to offer a range of advantages in delaying development of
age related disorders. Any nutritional supplement, which offers
ingredients having significant antioxidant activity, can have positive
impact on age associated disorders. Studies also claim that optimal
intake of antioxidant nutrients may contribute to enhanced quality of life and decelerated ageing. |
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| References |
 Neurology 1994;44:1593-600
J Postgrad med 2003;49:352-60
Eur Respir J 2003; 21:70S-75S
Physiol Behav. 1999 Apr;66(2):193-197.
Clin Geriatr Med 2002;18:699-708.
Cochrane Database Syst Rev 2002;1:CD000254.
Arthritis Rheum 1996;39:648-56.
J Postgrad Med 2003;49:229-35
Indian J Biochem Biophy 1994;31:261-6 |
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